The promise of coming guaranteed access to health benefits seems of little comfort to the majority of Californians who, in a new study, reported trouble affording health care and anxiety over potential financial hardship due to the steep cost of care.
A new Field Poll of 997 registered California voters showed 53 percent had difficulty paying their health care bills. Almost half, 46 percent, said they've simply delayed seeking treatment in the past year due to the cost.
What's clear is that progress made since the federal Affordable Care Act was adopted in 2010 has done little so far to ease what pollsters called the "high level of concern" people feel about risks inherent in the health care system.
Similar questions posed by the Field Poll five years ago yielded pretty much the same results, with 54 percent of voters in 2007 having difficulty paying for their health care costs, compared with 53 percent today.
For his part, pollster Mark DiCamillo said he was surprised that discontent over health care costs hasn't soared over the five-year gap between the two surveys.
"I would have expected the proportion of people who say health care costs are a problem would have gone up," DiCamillo said, noting increases in premiums, co-pays and the price tag for medical services.
"But when you look under the hood, you're seeing different populations responding differently than in 2007," he said.
The biggest shift in findings from five years ago is a substantial drop – from 31 percent to 17 percent – in the proportion of voters 65 and older who say their health care costs are "very difficult" to pay. Experts said this may result from increased coverage of prescription costs for seniors on Medicare.
Still, it is far from clear that seniors are confident that coming changes in the health care system will be to their benefit, said Chris Perrone, of the nonprofit California HealthCare Foundation, which funded the new study as well as the one in 2007.
"I think there's as much anxiety and uncertainty today as ever about what the Affordable Care Act will mean for Medicare," Perrone said.
While seniors reported more confidence in their ability to cover health care costs, middle-aged respondents swung in the other direction. A greater proportion – 31 percent – of middle-aged voters age 40 to 49 now say their health costs are "very hard to afford," compared to 22 percent in 2007.
The independent, nonpartisan survey was done from June 21 to July 2, with 745 interviews conducted with voters on landlines and 252 on cellphones. The margin of error for polling was plus or minus 3.1 percentage points.
One of the most striking findings, DiCamillo said, is how vulnerable people feel because of the capricious nature of the commercial health care system in recent years.
"It's significant that voters are quite insecure about the health care system because they have fears of hard times," he said. "These are things we can track as the Affordable Care Act rolls out. Some of these outcomes may end up being alleviated."
When asked how exposed they felt to personal and financial risk, a majority of voters questioned seemed deeply worried.
For example, 54 percent of voters said they were very concerned about the possibility of facing financial hardships due to the cost of treatment.
In addition, 52 percent were very concerned about the possibility of having to go without health care coverage – or postponing needed care or medicines because of the prohibitive costs.
Finally, 51 percent said they are very concerned over being denied coverage or payment for a needed health treatment.
If consumers had to put off health care because of cost, the mostly likely thing to go was dental care. Fully 34 percent of respondents said they had delayed going to see a dentist in the past 12 months because of the cost.
Worries over the difficulty of paying for health care were more poignant in households with annual incomes of less than $40,000, in which voters were four times as likely as those earning $100,000 or more – 43 percent to 11 percent – to say they have great difficulty in managing their health care costs, the study said.
Once the California Health Benefit Exchange ramps up for full implementation in 2014, low- to middle-income households will be able to qualify for subsidies for more affordable health insurance, experts say.
In addition, a host of other measures intended to make health care more affordable will come online in 2014, perhaps boosting results of the next such Field Poll the California HealthCare Foundation intends to fund.
"The survey results point to opportunities for improvement and challenges ahead," Perrone said. "I anticipate we will be doing a number of things to monitor results as health care reform moves forward."